Serum epidermal growth factor receptor and p53 as predictors of lung cancer risk in the ATBC study

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Abstract
Serum samples from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study were used in a nested case control study to identify the possible association between the serum level of epidermal growth factor receptor and p53 in respect to lung cancer. The proteins were assayed for by commercial immunoassays that showed uneven, often unacceptable, quality. For EGFR there was no relationship to lung cancer. Two physiological variables appeared to modify the serum level of EGFR, age by decreasing it annually by about 4 fmolml-1, and stroke by increasing it by 150 fmolml-1. For p53, myocardial infarction appeared to cause an increase in serum levels of this protein. While the serum levels of p53 were only moderately increased in lung cancer patients, particularly those with squamous cell carcinoma, the intriguing findings related to the high frequency of p53-positive patients among those belonging to the group of patients being treated by surgery and those belonging to clinical stages 1 and 2 as compared with higher clinical stages. An untested rationalization of these results was that patients with advanced lung cancer, stages 3 and higher, develop autoantibodies against the mutant p53 and thus mask the serum levels of the mutant p53 protein.